Insulin Pen—The “iPod” for Insulin Delivery (Why Pen Wins over Syringe)

Abstract

Diabetes affects most aspects of everyday life and places considerable responsibility on the patient; therefore, without patient acceptance of what we offer, the therapy is unlikely to be adhered to especially when that therapy happens to be insulin injection. In 2008, almost every physician/health care provider carries new and sleek cell phones (because the newer ones are well designed and function better). Why these same providers continue to prescribe insulin via syringes in 2008 is something that I cannot fathom. Previously, some insurance companies only paid for vials and there was no other choice, but today almost all insurance pay for pens and so the "insurance reason" is no longer tenable. Since Banting and Best discovered insulin in 1921, scientists have continued to improve the types of insulin (making them mimic physiology more closely in order to minimize hypoglycemia and improve glycemic control as seen with the latest analog insulins). In the same manner, the delivery process of insulin has also continued to evolve to make it easier and more acceptable to patients. Studies have shown that patients prefer device use over traditional vials/syringes. Pen devices used to inject insulin lead to better compliance, are quicker to inject, dosing is much more accurate, and, surprisingly, are more cost effective. I challenge my colleagues to take full responsibility for what their patients use. If a provider believes in pen devices, most of his/her patients will use them. The products your patients use is a direct reflection of what you practice. Educating providers to change their beliefs and practices is key to moving American diabetic patients from syringes to pen devices.

Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in patients with type 1 and type 2 diabetes mellitus in Lebanon

“… 13 This finding was emphasized by Asamoah in his article titled “Insulin pen-the ‘iPod’ for insulin delivery (why pen wins over syringe)”. 14 An explanation of such cost saving is the possibility of less insulin wastage due to expiration with the insulin pen since one vial contains 1,000 units of insulin as compared of one box of 5 pens containing 1,500 units of insulin in total. 3 Another study, by Lee et al analyzed patients’ adherence and hypoglycemic incidents in patients who converted to pen use.…”

Factors Associated with Persistence and Resumption of Insulin Pen Use for Patients with Type 2 Diabetes

“…7,23 Research demonstrates that convenience (or less lifestyle interference) is not only associated with increased satisfaction, but also with greater medication regimen adherence. 24 Another set of associations implicated affordability as an important factor in persistence of pen use. Patients who gave better ratings on the cost of pens and those with better insurance coverage (private or Medicare) were less likely to terminate their pen use.…”

NovoPen Echo® insulin delivery device

“…7 In addition, they are very fine, short, and lubricated needles, reducing the painful bruising and bleeding that can be experienced with longer and thicker needles. 6 , 31 – 33 NovoTwist needles are designed to attach and detach NovoPen insulin devices using a twisting motion to increase the patient’s ease of use. 8…”

“… 2 Although it has been demonstrated that insulin pen devices are preferred by patients, vials and syringes are still widely used, even in industrialized countries such as the US. 6 …”